Percutaneous endoscopic transforaminal decompression surgery for symptomatic double-level lumbar spinal stenosis with...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Surgery

Background:

• Lumbar spinal stenosis (LSS) with ossification can cause significant pain and disability.
• Double-level LSS presents unique surgical challenges.
• Percutaneous endoscopic transforaminal decompression (PETD) is a minimally invasive option for LSS.

Purpose of the Study:

• To evaluate the short-term efficacy and safety of double-level PETD for symptomatic double-level LSS with ossification.
• To assess the impact of PETD on spinal canal decompression, lumbar stability, and patient-reported outcomes.

Main Methods:

• A prospective study of 28 patients with double-level LSS who underwent double-level PETD.
• Pre- and postoperative MRI (DSCA), White-Panjabi (WP) scores, VAS, and ODI were assessed.
• Surgical outcomes were evaluated using modified Macnab criteria at 1-year follow-up.

Main Results:

• Postoperative MRI showed significant dural sac cross-sectional area (DSCA) enlargement at L3/4 and L4/5 (P<.001).
• Significant reductions in VAS and ODI scores were observed at 3 days, 3 months, and 1 year postoperatively (P<.001).
• The modified Macnab criteria showed an excellent outcome rate of 92.9% at 1-year follow-up, with minimal complications.

Conclusions:

• Double-level PETD is an effective treatment for symptomatic double-level LSS with ossification.
• The procedure provides significant spinal canal decompression and symptom relief with preserved lumbar stability.
• PETD is a safe and recommended surgical option with a low risk of complications and reoperation.